Preparing for a pandemic

Published on Friday 12 June 2009 10:10

The H1N1 virus has now reached such a stage geographically that the WHO has raised the alert level from five to six.

And while normally such an accelerated health alert would prompt confusion and panic, the truth is both NHS Lothian and the Scottish Government have been ready to swing into action for several weeks.

Health chiefs in Edinburgh have already revealed that once a pandemic was announced, NHS Lothian would look to inoculate everyone in the Lothians, a total of around 800,000 people.

But health secretary Nicola Sturgeon, who would have to sanction such a vast vaccination programme, said yesterday a pandemic status would not lead to radical action in this country, or at least not on the frontline.

Vaccines are already being bought by Holyrood to distribute around health boards, and the pandemic status itself contractually triggers a series of orders placed by health officials.

It is likely any mass vaccination would take place around autumn, with health chiefs probably abandoning their traditional winter flu vaccine to make way for it.

Businesses will be hit if predictions of one in four staff being off work this winter prove true – not only through people being sick but also those taking time off to look after their children who will be more at risk. But a humanitarian crisis is highly unlikely, in Scotland at least.

Bizarrely, it is those who would generally be deemed most vulnerable to a new strain of flu that seem to be safer, with some medics saying this is because previous strains of H1N1 in decades past may have crept into older peoples' systems, giving them a natural resistance to it. Dr Sheila Burns, an expert in influenza at Edinburgh University who is also one of the key members within NHS Lothian overseeing the preparations for the pandemic, said: "Influenza does affect those with diabetes, heart and breathing problems more and this tends to be in the over 60s, so from that point of view it's fortunate," she said. "We look at both best and worst-case scenarios and I think we are now seeing a best-case scenario – although it is impossible to predict what will happen over the summer.

"Because it is a new virus it is spreading fast because people don't have any immunity to it, but it is less aggressive than other strains of flu which kill people every year in this country.

"A lot of the hysteria surrounding it has to do with the word 'swine' when in fact most flu has some kind of animal strain – it's just the nature of it – and of course it is a new thing.

"But we got a wake up call a few years ago with avian flu, and now we are pretty well prepared."

The pandemic announcement is merely a formality and a recognition that it is now prevalent in all continents and increasing all the time, rather than an indication that people are suddenly at a higher risk. For example, Aids is regarded as a pandemic, but isn't a threat to the general population.

Even within Scotland, the Lothians – perhaps with the exception of West Lothian – is at far less risk of the infection than the west coast. Many experts have said the poorer health of those in and around Glasgow and Lanarkshire, makes them more susceptible.

West Lothian has seen far and away the most cases locally, and this is because people there are deemed to have more links with Glasgow, on top of which it is accepted that people in that region are generally unhealthier than Edinburgh and the other Lothians.

And there will be a number of people in the Lothians who will have had the virus but shaken it off or persevered through it due to superior wellbeing.

It is expected that the summer will see a continuation of the infection,

but once the weather cools and it becomes easier for the bug to spread, more will suffer.

If it spreads as potential allows it, every town and city in the land will have a number of cases, but as it stands a relatively small amount of people have required hospital treatment.

The last global flu pandemic occurred in 1968, when between 700,000 and one million people lost their lives to the Hong Kong flu. However, the world will have learned lessons from that and is far better prepared this time around.

While the bird flu scare threatened much, besides a dead swan washed up in Cellardyke harbour, there were no Scottish casualties.

Health secretary Nicola Sturgeon yesterday revealed a change in approach by Holyrood to stay on top of the problem.

She said: "It is important to stress that as we are already operating at a heightened state of readiness, a move to level six will not trigger any material change in our response.

"There's no doubt in my mind the changes, the refinements, to our containment strategy are right.

"They are based on expert evidence. They will allow us to ensure that resources are targeted to best effect in order to continue, as far as we can, to minimise the spread of the infection."